There is a lack of uniformity in functional urology teaching during postgraduate urology training across Canada. Therefore, we aimed to identify extents of deficiency in functional urology education, and to develop an infrastructure that incorporates learning material, tools, and facilities into a uniform educational system.

This is a retrospective study of a functional urology education assessment of 18 chief urology residents from eight different Canadian training institutions. The data was collected during a comprehensive two-day functional urology course designed for Canadian chief urology residents. Residents answered a basic questionnaire immediately prior to a pre-course assessment exam, in which they evaluated their competency (self-evaluation of competency to manage independently patients with voiding dysfunction), certainty (overall self-perceived confidence level upon managing patients with voiding dysfunction) and satisfaction (satisfaction level with regard to the overall effectiveness/quality of functional urology teaching during residency) in this urology subspecialty.  Their performance in functional urology was assessed with a comprehensive written exam of short answers and multiple-choice questions, before and after the course completion, intended to be comparable to the format of the Royal College of Surgeons of Canada urology examination.

Overall, residents (n=18) achieved significantly higher post-course total score (78.6 % post course versus 55.4% pre-course, P =0.001), with an estimated mean percentage of change of approximately 44%. Based on a 5-point Likert scale (1 to 5), the self-reported mean results were for competency 3.11 (±0.676), overall certainty 3.55 (±0.783), and satisfaction score 3.16 (± 0.707). Overall competency and satisfaction level significantly correlated with pre-course scores (P<0.05). Eleven participants (60%) reported that they need more training, and 7 (30%) reported an insufficient number of cases or not enough time. Most of the participants (67%) reported problem-based learning as the most preferred teaching method, while 28% preferred real patient practical sessions. 13 residents (72%) confirmed that adding more dedicated training sessions within curriculum and extra courses as the most helpful suggestion to improve their competency level.

The significant correlation of pre-course scores with competency and satisfaction level among functional urology knowledge and clinical application indicates a gap in resident’s experience in functional urology. The higher post-course test score is reflective of the level of competency of chief residents, and the improvement achieved with a 2-day focused course. Despite the development of minimum education standards for urology training, it is unclear whether residents are graduating with the essential skill set particularly for this filed of urology.

Institutions need to offer consistent and uniform post-graduate training across all urology sub-specialties to ensure adequate skill acquisition by their final year. These findings highlight the need to integrate more interactive problem-based training sessions and extra-curricular teaching tools into functional urology training curriculum. This may consolidate learner engagement and improve training effectiveness and continuity of care.